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Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The aims of this study were to quantify the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE) and to explore any differences between respondents.

Methods

A cross-sectional survey of patient-facing doctors, nurses and pharmacists within three major hospitals of Abu Dhabi, the UAE. An online questionnaire was developed based on the Theoretical Domains Framework (TDF, a framework of behaviour change theories). Principal component analysis (PCA) was used to identify components and internal reliability determined. Ethical approval was obtained from a UK university and all hospital ethics committees.

Results

Two hundred and ninety-four responses were received. Questionnaire items clustered into six components of knowledge and skills, feedback and support, action and impact, motivation, effort and emotions. Respondents generally gave positive responses for knowledge and skills, feedback and support and action and impact components. Responses were more neutral for the motivation and effort components. In terms of emotions, the component with the most negative scores, there were significant differences in terms of years registered as health professional (those registered longest most positive, p = 0.002) and age (older most positive, p < 0.001) with no differences for gender and health profession.

Conclusion

Emotional-related issues are the dominant barrier to reporting and are common to all professions. There is a need to develop, test and implement an intervention to impact health professionals’ emotions. Such an intervention should focus on evidence-based behaviour change techniques of reducing negative emotions, focusing on emotional consequences and providing social support.

Key messages

• This research used the Theoretical Domains Framework to quantify the behavioural determinants of health professional reporting of medication errors.

• Questionnaire items relating to emotions surrounding reporting generated the most negative responses with significant differences in terms of years registered as health professional (those registered longest most positive) and age (older most positive) with no differences for gender and health profession.

• Interventions based on behaviour change techniques mapped to emotions should be prioritised for development.

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References

  1. Kohn LT, Corrigan JM, Donaldson MS (2000) To err is human: building a safer health system. National Academies Press

  2. National Coordinating Council for Medication Error Reporting and Prevention. Available at http://www.nccmerp.org [accessed July 2016]

  3. Bahadori M, Ravangard R, Aghili A, Sadeghifar J, Gharsi Manshadi M, Smaeilnejad J. (2013) The factors affecting the refusal of reporting on medication errors from the nurses’ viewpoints: a case study in a hospital in Iran. ISRN Nursing 876563

  4. Wakefield DS, Wakefield BJ, Uden-Holman T, Borders T, Blegen M, Vaughn T (1999) Understanding why medication administration errors may not be reported. AJMQ 14(2):81–88

    Article  CAS  Google Scholar 

  5. Stratton KM, Nlegen MA, Peppper G, Vaughn T (2004) Reporting of medication errors by pediatric nurses. J Pediatr Nurs 19:385–392

    Article  PubMed  Google Scholar 

  6. Wild D, Bradley E (2005) The gap between nurses and residents in a community hospital’s error-reporting system. JQPS 31(1):13–20

    Google Scholar 

  7. Evans SM, Berry JG, Smith BJ, Esterman A, Selim P, O’Shaughnessy J, et al. (2006) Attitudes and barriers to incident reporting: a collaborative hospital study. Qual Saf Health Care 15(1):39–43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Patrician PA, Brosch LR (2009) Medication error reporting and the work environment in a military setting. JNCQ 24(4):277–286

    PubMed  Google Scholar 

  9. Sarvadikar A, Prescott G, Williams D (2010) Attitudes to reporting medication error among differing healthcare professionals. Eur J Clin Pharmacol 66:843–853

    Article  PubMed  Google Scholar 

  10. Chiang H, Lin S, Hsu S, Ma S (2010) Factors determining hospital nurses’ failures in reporting medication errors in Taiwan. Nurs Outlook 58(1):17–25

    Article  PubMed  Google Scholar 

  11. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M (2008) Developing and evaluating complex interventions: the new Medical Research Council guidance. Brit Med J 337:a1665

    Google Scholar 

  12. Cane J, O’Connor D, Michie S (2012) Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 7:37

    Article  PubMed  PubMed Central  Google Scholar 

  13. Francis JJ, O’Connor D, Curran J (2012) Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci 7:35

    Article  PubMed  PubMed Central  Google Scholar 

  14. Alqubaisi M, Tonna A, Strath A, Stewart D (2016) Exploring behavioural determinants relating to health professional reporting of medication errors: a qualitative study using the theoretical domains framework. Eur J Clin Pharmacol 72:887–895

    Article  PubMed  Google Scholar 

  15. SEHA Annual Report 2. The changing face of healthcare. Abu Dhabi Health Services Co. Available at http://docplayer.net/2810751-Abu-dhabi-health-services-company-pjsc-seha-annual-report-2012-annual-report-2012-the-changing-face-of-healthcare.html

  16. Health Authority Abu Dhabi Medication Error Reporting Policy version 1, 2009. Available at http://www.haad.ae/haad/tabid/58/Mid/417/ItemID/225/ctl/Details/Default.aspx [Accessed July 2016]

  17. Huijg JM, Gebhardt WA, Dusseldorp E, Verheijden MW, van der Zouwe N, Middelkoop BJ, et al. (2014) Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework. Implement Sci 9

  18. Krejcie RV, Morgan DW (1970) Determining sample size for research activities. Educ Psychol Meas 30(3):607–610

    Google Scholar 

  19. Osborne JW, Costello AB (2009) Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pan-Pacific Management Review 12(2):131–146

    Google Scholar 

  20. Hayton JC, Allen DG, Scarpello V (2004) Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. ORM 7(2):191

    Google Scholar 

  21. Nunnally JC. (2010) Psychometric theory. Tata McGraw-Hill Education

  22. Evans SM, Smith BJ, Esterman A, Runciman WB, Maddern G, Stead K, et al. (2007) Evaluation of an intervention aimed at improving voluntary incident reporting in hospitals. Qual Saf Health Care 16(3):169–175

    Article  PubMed  PubMed Central  Google Scholar 

  23. Michie S, van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6:42

    Article  PubMed  PubMed Central  Google Scholar 

  24. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. (2013) The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 46(1):81–95

    Article  PubMed  Google Scholar 

  25. Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W (2015) Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data. Health Technol Assess 19(99)

  26. Halligan M, Zecevic A Safety culture in healthcare: a review of concepts, dimensions, measures and progress. BMJ Qual Saf 20(4):338–343

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Acknowledgments

The authors would like to acknowledge the following for their contribution and support provided throughout this research: Embassy of the United Arab Emirates for funding Mai Alqubaisi’s doctoral studies; Katie MacLure, Gordon Rushworth, Cristin Ryan and Anne Watson for reviewing the draft questionnaire; the ethical review panels and Human Resources Departments of all participating hospitals; and all survey respondents.

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Correspondence to Derek Stewart.

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Competing interests

Mai Alqubaisi, Antonella Tonna, Alison Strath and Derek Stewart declare that they have no conflict of interest.

Funding

Funding for Mai Alqubaisi’s doctoral studies was provided by the Embassy of the United Arab Emirates.

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Alqubaisi, M., Tonna, A., Strath, A. et al. Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework. Eur J Clin Pharmacol 72, 1401–1411 (2016). https://doi.org/10.1007/s00228-016-2124-z

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  • DOI: https://doi.org/10.1007/s00228-016-2124-z

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